LEAVE REQUEST FORM

Copy - Benefits Delivery

Employee Name : Angelica Fermin Date :

Oracle ID: 5815763 Account/Dept./Section:
Position : Agent Supervisor's Name :
No.of Day/s Applied: 14 day(s) Leave Type : (please select only one)
Coverage Date(s): June 25, 2021 - July 8,2021 Maternity
Reason: Influenza Paternity
Emergency (only if with zero leave credits)
Other Statutory Leaves
Leave Of Absence (LOA) - 5 days & up
Note: Leave applications are subject to HRSD's validation
Requested by: Approved by:

06-26-21
Employee's Signature / Date Immediate Supervisor's Signature / Date
Verified by: Date encoded : INSTRUCTIONS:
1. Fill-out the form and sign.
2. Submit to supervisor/manager for approval.
HRSD Signature 3. Upon approval of supervisor, please submit to HRSD Office.

LEAVE REQUEST FORM

Copy - EE

Employee Name : Angelica Fermin Date :

Oracle ID: 5815763 Account/Dept./Section:
Position : Agent Supervisor's Name :
No.of Day/s Applied: 14 day(s) Leave Type : (please select only one)
Coverage Date(s): June 25 2021 - July 8, 2021 Maternity
Reason: Influenza Paternity
Emergency (only if with zero leave credits)
Other Statutory Leaves
Leave Of Absence (LOA) - 5 days & up
Note: Leave applications are subject to HRSD's validation
Requested by: Approved by:

06-26-21
Employee's Signature / Date Immediate Supervisor's Signature / Date
Verified by: Date encoded : INSTRUCTIONS:
1. Fill-out the form and sign.
2. Submit to supervisor/manager for approval.
HRSD Signature 3. Upon approval of supervisor, please submit to HRSD Office.

HRSD-MANAGED LEAVES: 4. SOLO PARENT LEAVE (SPL)

https://engage.alorica.com/philippines/leave-filling-process/
1. EMERGENCY LEAVE (EL)
a. 5 days paid leave in a year (not convertible to cash).
i. Employee must have a tenure of one (1) year to avail the benefit.
ii. Employee must have zero in-lieu (IL) and PTO/LPTO credits left to utilize.
iii. Must be filed via Leave Request Form, with supporting documents.
b. EL credits are refreshed annually, and any unused EL credits by the end of the year is forfeited.
c. Must meet the criteria under valid Emergency Leave reasons:
i. Illness or injury of the employee or any immediate members of the employee’s family such as legitimate spouse and
children (for married employees) or parents, children and siblings, and guardian (for single employees).
ii. Death of any of the members of the employee’s family such as legitimate spouse, children, parents, parents-in-law,
grandparents, siblings and guardians.
iii. Calamities or Force Majeure and other emergencies that the employee may suffer;
2. PATERNITY LEAVE (PL)
a. 7 days paid leave for all legally married male employees, regardless of tenure (not convertible to cash).
i. Applicable for live birth or miscarriage, up to four (4) children only;
ii. May be utilized incrementally within:
b. 60 days of child’s birth date, if delivered normally or;
c. 78 days of child’s birth date, if delivered via c-section.
i. Must be filed using the Leave Request Form with supporting documents.
ii. Requirements: Marriage Certificate and child’s Birth Certificate (not required to be NSO Certified);
3. MATERNITY LEAVE (ML)
a. 60 days leave for Normal Delivery & Miscarriage, and 78 days for Caesarian Delivery.
i. Availed via the SSS Maternity Benefit, up to four (4) pregnancies only.
ii. Employee must have at least 3 months’ worth of SSS contribution prior to the semester of pregnancy.
iii. In accordance with SSS mandate, ML dates are automatically adjusted in the system following the employee’s actual
delivery date.
iv. Requirements and forms are available from the site HRSD Coordinators, or through HRSD Engage.
v. Filing & crediting timelines:
b. Mat 1 should be filed within 1st trimester of pregnancy, and benefit is credited 2-3 weeks before delivery.
c. Mat 2 should be filed within 30 days after the delivery date, and benefit is credited 2-3 weeks upon submission of
complete requirements.
a. 7 days paid leave (yearly, not convertible to cash).
b. Employee must have a tenure of one (1) year to avail of this benefit.
c. SPL credits are refreshed annually, and any unused SPL credits by the end of the year is forfeited.
d. Must be filed using the Leave Request Form with supporting documents.
e. Requirements: Photocopy of Solo Parent ID (front & back) issued by DSWD – must be
valid/unexpired;
5. MAGNA CARTA FOR WOMEN (MAGNA CARTA)
a. Maximum of 60 days paid leave per year.
b. Employee must have undergone surgery for gynecological disorders, certified by a competent
physician.
c. Employee has rendered at least 6 months’ continuous employment for the last 12 months prior to
surgery.
d. The employee must have zero in-lieu (IL), PTO/LPTO, and emergency leave (EL) credits left to
utilize if also claiming for the SSS Sickness Benefit.
e. Requirements and forms are available from the site HRSD Coordinators, or through HRSD Engage.
6. VIOLENCE AGAINST WOMEN & CHILDREN (VAWC)
a. 10 days paid leave (yearly, not convertible to cash).
b. Must be filed using the Leave Request Form with supporting documents.
c. Requirements: Certification from Barangay Chairman, Barangay Councilor, Prosecutor or Clerk of
Court;
7. LEAVE OF ABSENCE (LOA)
a. Employee must have zero in-lieu (IL), PTO/LPTO, or emergency leave (EL) credits left to utilize;
b. Must be filed using the Leave Request Form with supporting documents.
c. Degree of approval for long-term LOA
i. 5-29 days – must be approved by account/program Director
ii. 30 days & above – must have Director approval, and HRSD Sr. Director approval c/o Benefits